Salomone Federico, Sharaiha Reem Z, Boškoski Ivo
Division of Gastroenterology, Ospedale di Acireale, Azienda Sanitaria Provinciale di Catania, Italy.
Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA.
Liver Int. 2020 Jun;40(6):1262-1268. doi: 10.1111/liv.14441. Epub 2020 Apr 6.
Non-alcoholic fatty liver disease (NAFLD) has become the most common liver disease in industrialized countries because of the worldwide epidemic of obesity. Beyond metabolic complications, a subset of patients with NAFLD develop non-alcoholic steatohepatitis (NASH) with fibrosis, which is emerging as a leading cause of liver transplantation due to progression to cirrhosis and cancer. For these reasons, NAFLD is considered a public health burden. In recent years endoscopic bariatric and metabolic therapies (EBMT) have emerged as safe and effective for the treatment of obesity and type 2 diabetes mellitus. EBMT include gastric and duodenal devices and techniques such as intragastric balloons, endoscopic sleeve gastroplasty, endoscopic small bowel by-pass and duodenal mucosal resurfacing. Observational studies and pilot trials have revealed beneficial effects of EBMT on NAFLD as assessed by non-invasive parameters or histology. In this review we summarise current evidence for the efficacy and safety of EBMT in obese patients with NAFLD and examine future clinical applications.
由于全球肥胖症的流行，非酒精性脂肪性肝病（NAFLD）已成为工业化国家最常见的肝脏疾病。除代谢并发症外，一部分NAFLD患者会发展为伴有纤维化的非酒精性脂肪性肝炎（NASH），由于其会进展为肝硬化和癌症，正逐渐成为肝移植的主要原因。基于这些原因，NAFLD被视为一种公共卫生负担。近年来，内镜下减肥和代谢疗法（EBMT）已成为治疗肥胖症和2型糖尿病的安全有效方法。EBMT包括胃和十二指肠装置及技术，如胃内球囊、内镜袖状胃成形术、内镜小肠旁路术和十二指肠黏膜重塑。观察性研究和试点试验表明，通过非侵入性参数或组织学评估，EBMT对NAFLD有有益作用。在本综述中，我们总结了EBMT在肥胖NAFLD患者中的疗效和安全性的当前证据，并探讨其未来的临床应用。
